Connecticut’s ‘health exchange-in-a-box’ for struggling states

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Connecticut is getting entrepreneurial with its healthcare exchange. AccessHealth CT has done so well that it started getting calls for help and advice from other states.

“And so we’ve had discussions with those states,” says AccessHealth CT’s CEO, Kevin Counihan. “And it came to us that there could be a business model here.”

Connecticut is now setting up a consulting business to help other states copy its success. The model is called “exchange-in-a-box,” a term healthcare consultants at Leavitt Partners says they coined a few years ago in a white paper trying to market the concept to states.

Counihan and his team are going to sell three different kinds of “products.” A state can really splurge and buy a premium package in which Connecticut handles everything, from the technology to sales and marketing to vendor management. The second model is more “stripped down,” says Counihan. States can pick and choose from a menu of services. Or they can simply license the Connecticut exchange’s technology.

“Connecticut seems to be looking for revenue,” says Alan Weil, executive director at the National Academy for State Health Policy. “I don’t know how much they can earn, but it’s an innovative way to generate it.”

The state healthcare exchanges do ultimately have to be self-supporting, says Counihan, and consulting revenue will help Connecticut’s do that. Many states want the help, including the ones that now regret letting the federal government run their exchanges.

Dan Schuyler, senior director of exchange technology at Leavitt Partners, says using this “exchange-in-a-box” solution potentially cuts start-up times in half. “You could have a state-based exchange up and running in about 12 to 16 months, versus 18 to 24 months or longer.”

Joel Ario, former director of the Office of Insurance Exchanges at the Department of Health and Human Services, says the idea of outsourcing their exchanges may hold a lot of appeal in conservative states, where the idea of hiring a lot of government employees isn’t politically palatable.